Cholesterol

There is a lot of hype about cholesterol and the risk of heart disease. But we need to remember that cholesterol is essential for life. It is a steroid compound that contributes to the structural integrity of cell membranes and is needed for repair and stability of cell membranes. Cholesterol is also a precursor for the synthesis of steroid hormones such as testosterone, progesterone, estrogen and DHEA. Cholesterol is needed to manufacture bile, a component of the myelin sheath around our nerves cells and cholesterol has beneficial effects on the immune system.

Cholesterol comes from food in our diet, but is also manufactured by our liver. Although cholesterol is very important for us too much serum-cholesterol is associated with an increased risk of developing heart disease.

Cholesterol is divided into different groups including low-density lipoprotein (LDL) which correlates with increased risk of heart disease and high-density lipoptotein (HDL) which correlates with a decreased risk.

Animal studies suggest that cholesterol is a relatively benign molecule, but oxidised cholesterol is very toxic to blood vessels. Cholesterol in the blood stream is constantly in contact with oxygen, there is a tendency for cholesterol to undergo oxidation by free radicals. So a diet high in antioxidants such as fruits and vegetables or supplementing with anti-oxidants might counteract the conversion of cholesterol to cholesterol oxides (a free radical).

Dietary Considerations

A cholesterol lowering diet should be low in total fat and refined sugar (refined sugar lowers HDL cholesterol in some people).

Foods that have been shown to reduce serum cholesterol include soy products, carrots, oat bran, yoghurt, walnuts, garlic, onions and alfalfa sprouts. High-fibre foods (such as whole grains, legumes, fruits and vegetables) may also help to lower cholesterol levels.

It is important to understand the different fats. We should reduce out intake of fats high in saturated fat such as red meat and dairy products. Chicken and turkey do contain saturated fat but less than red meat. Fish contains almost entirely 'good' unsaturated fats.

Although some margarine is made with 'good' unsaturated fats, they contain trans-fatty acids which are probably worse than eating saturated fat. So if you must use one a small amount of butter is better.

From a clinical nutrition point of view, milk is for cows not people. There is increasing evidence for homogenised milk as a cause of atherosclerosis and heart disease. You only need to think of nations that have a high dairy content to their diet and the levels of heart disease in those countries.

There is soy milk and ice cream and rice milk and goats cheese as alternatives. Soy and eggs are the only foods that contain phospholipids which have a unique function of keeping brain cell membranes healthy. Soy has also been shown to lower serum cholesterol.

Eggs do contain approximately 300mg of cholesterol but they contain approximately 1500mg of phospholipids. These phospholipids off set any possible adverse effects of egg cholesterol. Plus also helping with the brain cell membranes and if we remove eggs and a lot us people do not eat soy products then you are not getting your phospholipids.

Below is the recommendation from the American Heart Association for those with cardiovascular disease.

Diets for Hypercholesterolemia and Dyslipidemia

The third report of the Adult Treatment Panel (ATPIII) of the National Cholesterol Education Program (NCEP) recommends the following intake levels: saturated fat of no more than 7% of total calories, cholesterol limited to less than 200 mg/day, little to no trans fatty acids, intake of both plant stanols/sterols (2 g/day) and soluble fiber (10 to 25 g/day); weight loss and exercise are also recommended (Expert Panel on Detection, Evaluation and Treatment of High Blood Cholesterol 2001). Soy protein in place of animal protein in the diet may aid in decreasing serum levels of total cholesterol, LDL cholesterol, and triglycerides without affecting HDL cholesterol levels (Anderson et al. 1995; FDA 1999).

The AHA also recommends a high unsaturated-fat diet as an alternative to a very low-fat diet for individuals with atherogenic dyslipidemia (high triglycerides, low HDL cholesterol, and small LDL particles; may be a part of the metabolic syndrome which also includes abdominal obesity, hypertension, and insulin resistance). Total and LDL cholesterol levels can be reduced by replacing saturated fats with unsaturated fats or carbohydrates. Unsaturated fats may also prevent or reduce a decrease in HDL cholesterol (Krauss et al. 2000).

Role of food intolerances

For those who have adjusted their diet, used medication and or supplements and have not been able to lower their cholesterol levels you could consider possible food intolerances. For more information see Food intolerance or allergy.

Nutritional supplements

Nutritional supplements can be used along side cholesterol lowering medication. When purchasing supplements do let us know if you are on any medication as some interactions do occur.

OMEGA 3

There is strong evidence that the long-chain omega-3 polyunsaturated fatty acids docosahexaenoic acid (DHA) and eicosapentaenoic acid (EPA) contained in fish oil can aid in the prevention and treatment of coronary artery disease by inhibiting the development of atherosclerotic plaques, thrombosis, and arrhythmia. For more information see www.omega-research.com

Many studies show a variety of nutrients been helpful in lower cholesterol.

Pantethine 300mg 2 to 4 times per day

Inositol hexanicotinate, 500 g twice daily plus chromium 200 to 500mcg daily.

Niacin combined with chromium

Vitamin C, Vitamin E, Selenium.

Herbs to help lower cholesterol

Hawthorn

Garlic

Green tea

Guggulipid

Additional Information

After dietary and exercise advice, I recommend those with high cholesterol to take Nortic Naturals EPA capsules. The positive effects can be seen as soon as 2 to 3 weeks.